We recently visited Dr. Trey Crisco at the Bioengineering Lab in
the Department of Orthopaedics at Rhode Island Hospital and Brown
Medical School in Providence, Rhode Island. Through a study funded
by NOCSAE (National Operating Committee on Standards for Athletic
Equipment) and US Lacrosse, Crisco is testing and measuring head
accelerations from stick checks in girls and women's lacrosse.

Crisco, a member of the US Lacrosse Sports Science and Safety
Committee and the director of the bioengineering lab at Brown, is
also the father of three daughters, ranging in age from 13 to 22,
who have all played or are still playing lacrosse. He has coached
girls' youth lacrosse for 12 years and was the goalie coach and
junior varsity coach at Yale University during his graduate school
years. He wholeheartedly supports maintaining the unique culture of
girls' and women's lacrosse.

LM: Walk us through the logistics of setting up this
head acceleration study?

TC: The primary aim of this part of our study
is to understand the relationship between stick checks and head
accelerations. This grant that we received through both US Lacrosse
and NOCSAE is just one piece in trying to understand what the
potential injury mechanism is for head injuries in girls' lacrosse.
Previously, there have been epidemiological studies and
surveillance studies that have found that the majority of head
injuries in girls' lacrosse occur from the stick. These are
inadvertent, obviously, and could be a result of follow-throughs
from shots, or fore checks. Unlike the boys' game, where head
injuries are dominated by body-to-body or head-to-head contact, in
the girls, we don't see that; but we are seeing the stick impacting
the head. So the goal of this study was to get an understanding of
the relationship between the severity of the stick checks and the
resulting head accelerations.

Do we know that certain rates of acceleration equal
certain severities of injury?

That's the holy grail of concussion studies, to document the
relationship between head acceleration and concussion. We're not
there yet. We know that above 90Gs or 120Gs, you are more likely
than not to get a concussion, but there's not a definitive
threshold. It's unlikely that there will be across all people
because people are different and there's variability. But there are
other factors, like where you get hit and what your previous
exposures were. We're still in the process, through other studies,
of coming up with that relationship.

Were the stick speeds used by the subjects in the study
similar to real-game stick speeds?

We had the girls in this study check the head form at medium
severity and then again with their most aggressive motion. We would
never expect to see those types of accelerations in a game, so we
are being conservative. We have a pretty good idea of where college
stick speeds are. This study will give us a pretty good idea of
where youth girls' stick speeds are. The impacts that we are
measuring are at the upper end of the severity.

How much does player age matter in the relevancy for
this study?

From our related studies in other sports, we know that the only
thing that is going to differ is the speed of the stick. All the
other factors, like player size, reduce to stick speed. When we
finish collecting the data, we'll have an entire spectrum of data,
going from youth to college, and then we'll be able to see what
those differences are, but we think that the severity of the
impacts will vary by stick speeds and not by group. Clearly, stick
speeds increase by age and experience.